title: Complementary and alternative medicine use among older urban African Americans: individual and neighborhood associations.
abstract: OBJECTIVE
  Older African Americans may be vulnerable to risks due to impaired healthcare access and understudied complementary and alternative medicine (CAM) use and other traditions. We describe CAM use among older African Americans in Baltimore, MD, examining associations among CAM and sociodemographic, health status, healthcare utilization and neighborhood factors.
  
  
  METHODS
  Cross-sectional telephone survey of 95 African Americans ages > or =60 on use of CAM modalities (herb/home remedies, prayer, group spiritual practices, meditation/visualization, massage, chiropractic, acupuncture, relaxation/biofeedback) in prior year.
  
  
  RESULTS
  A large majority (88.4%) reported CAM use in the previous year: 50.5% reported CAM use excluding individual prayer. The most commonly reported modalities were individual prayer (96.8%), herbs/home remedies (29.5%) and group spiritual practices (17.0%). Most (77.3%) herbal/home remedy users disclosed use to providers. In multivariable logistic regression at the individual level, CAM was associated with higher number of comorbidities (OR = 1.24, 95% CI: 1.06-1.45), older age (OR = 1.09, 95% CI: 1.01-1.17) and more years of education (OR = 1.24, 95% CI: 1.03-1.49). Adding neighborhood variables attenuated effects of comorbidity (OR = 1.17, 95% CI: 0.99-1.39); residence in more racially integrated neighborhoods (OR = 1.03, 95% CI: 1.00-1.06; p = 0.047) was also important.
  
  
  CONCLUSIONS
  CAM use was greater than expected. Although disclosure of herb use was high, providers should probe for CAM use.
authors.affiliation: Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA. pryder@rx.umaryland.edu
authors.forename: Priscilla T
authors.initials: PT
authors.lastname: Ryder
authors.forename: Beverly
authors.initials: B
authors.lastname: Wolpert
authors.forename: Denise
authors.initials: D
authors.lastname: Orwig
authors.forename: Olivia
authors.initials: O
authors.lastname: Carter-Pokras
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Black
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D014505:Urban Population